Case Studies – Health Plan Operations
We partnered with the health plan from Day 0, assessing the gap between current and future operations and developing their roadmap to fulfill rigorous state readiness requirements—guiding our client’s approval with no critical findings.
Everything is bigger in Texas, including the list of requirements health plans must fulfill for approval to implement new systems. We worked closely with subject-matter experts (SMEs) to assess current operations and developed a comprehensive readiness plan to meet all state-required deliverables. On an accelerated timeline, we identified operational deficiencies and worked with SMEs to address them, while highlighting best practices aligned with requirements. Sage also facilitated all preparations for the state’s desk and on-site reviews, enabling our client to receive approval with no critical findings.
Facilitated desk top readiness completion for 50 state requirements
Reviewed and finalized over 200 evidence deliverables to support state approval
Led over 30 health plan leaders in the preparation for a successful on-site review
The Sage Difference
- In previous senior health plan leadership roles, Sage executives have spearheaded numerous successful procurements and readiness audits in multiple states
- Best practices recommended to the client were informed by our team’s deep understanding of health plan operations and Medicaid requirements
- Our team’s well-rounded perspective—spanning operations, population health, and product development—helped guide our client to build bridges internally to fulfill requirements
Key Improvement Activities
- Developed a readiness tracker for all stakeholders to document progress on state-required deliverables
- Provided strategic review, recommendations, and oversight of all deliverables to ensure compliance and readiness
- Guided all planning for the state on-site review, from deck preparation and speaker talking points to meeting logistics and dry run Q&A sessions
Woman-Owned Business (BEP-WBE) Certification Information
Sage Health Strategy is certified as a woman-owned business by the State of Illinois and County of Cook. Sage regularly partners with prime vendors in competitive government procurements within Illinois and around the country. Our prime vendor partners have ranged from privately held professional services firms to publicly traded companies. For more information on our work in this area, please contact us.
